99
In addition to the side effects reported by the Natural Standard, below, Mischoulon,
Fava and Stahl replied to a letter in the Journal of Clinical Psychiatry in June, 2009,^18 to
concerns about folate masking Vitamin B-12 deficiencies or affecting colorectal cancer.
Mischoulon et al. conceded that folate supplementation could mask a vitamin B- 12
deficiency, requiring extra care for vulnerable people. Brown et al. point out that this
problem of masking can be reduced by testing serum methylmalonic acid and
homocysteine levels.
As to cancer risk, Mischoulon and Rosenbaum give evidence for and against but in the
end recommend only counseling caution for people with a history of polyps or a family
history of colorectal cancer.
The Natural Standard gives age-calibrated dosages for children; Berkeley Wellness gives
a dose for pregnant women. Fugh-Berman adds that “we give folate specifically to
pregnant women, and it’s water-soluble so you can’t overdose.” Thus, there appears to
be no reason for children or pregnant or lactating women to avoid folate.
- DOSAGE:
The Natural Standard recommends: For infants up to 6 months old, 65 mcg. per day, 7-
12 months, 80 mcg. per day, 1-3 years, 150 mcg. per day, 4-8 years, 200 mcg. per day, 9-
13 years, 300 mcg. per day, 14-18 years, a maximum of 800 mcg per day, and adults, a
maximum of 1,000 mcg per day. Recommended dosages are 400 mcg per day for
adults, increasing to 500 mcg per day for breastfeeding women and 600 mcg per day
for pregnant women. For adjunct treatment with antidepressants, the Natural Standard
states that dosages of from 200 to 500 mcg per day have been used.
Berkeley Wellness is concerned about over-supplementation: The recommended
dietary allowance for folate is 400 - 1000 mcg per day for adults and 600 mcg per day for
pregnant women. But many Americans get much more than that, since about 40% of
those over age 60 take a multivitamin, which typically supplies the recommended
dietary allowance of folate. In addition, many people take a supplement of B vitamins
